Interventional pulmonology is a specialized sub specialty of Pulmonary Medicine using minimally invasive and percutaneous techniques for advanced diagnostic and therapeutic management of various lung disorders. Interventional pulmonology has evolved dramatically over the years, was initially used only to examine and sample the central airways, but has now broadened widely to not just diagnose but even treat various lung and pleura related diseases.
The primary application of interventional pulmonology is in the diagnosis, staging and palliative treatment of patients with lung cancer. Dilatation of tracheo-bronchial strictures, stenting of airways, removal of foreign body, management of unclassified pleural disorders and temporary percutaneous tracheotomies for chronic airway management also fall under the realm of interventional pulmonology.
The Department of Interventional Pulmonology (IP) has been developed specifically to cater to the evolving need of minimally invasive procedures for the diagnosis of infective and non-infective lung disorders, and the staging and palliative treatment of advanced lung cancer.
The department is well equipped with state-of-the-art bronchoscopy suite with most advanced diagnostic and therapeutic technologies required for performing these procedures, and early diagnosis and management of advanced lung diseases including lung cancer.
Services provided by the department of IP:
Broncho alveolar lavage (BAL), Endobronchial lung biopsy (EBLB), Transbronchial lung biopsy (TBLB), Brush biopsy, Cryobiopsy
Endobronchial Ultrasound (EBUS) is a technique that uses ultrasound along with bronchoscope to visualize airway wall and structures adjacent to it.
TYPES OF EBUS:
There are two forms of EBUS; radial and linear (convex).
INDICATIONS OF EBUS:
Additional contraindications to EBUS-TBNA are related to bleeding risk and include following:
EBUS and EBUS-TBNA are usually safe procedures. Reported complications are agitation, cough, hypoxia, laryngeal injury, fever, bacteraemia and infection, bleeding, pneumothorax and broken equipment becoming stuck in the airway.
Medical Thoracoscopy is a minimally invasive procedure that allows access to the pleural space (space between chest wall and lungs), using a combination of viewing and working instruments. It has become the second most important endoscopic procedure in respiratory medicine after bronchoscopy.
In rigid bronchoscopy, a long metal tube (rigid bronchoscope) is advanced into a person’s windpipe and main airways. The rigid bronchoscope’s large diameter allows the doctor to use more sophisticated surgical tools and techniques. Rigid bronchoscopy requires general anesthesia (unconsciousness with assisted breathing), like a surgical procedure. It is imperative to undergo evaluation by the physician as well as anesthesiologist prior to the procedure, which allows discussion of risks and benefits and correction of any reversible contraindication. After general anesthesia is administered, the patient is intubated with the rigid bronchoscope and attached to the ventilator.
Rigid Bronchoscopy is used in both therapeutic and diagnostic cases including: tumor excision, stent placement, foreign body removal and control of bleeding.
PATIENT EDUCATION FOR BRONCHOSCOPY
Interventional Pulmonology (Penn Medical Centre, Philadelphia)